Medical Aid and Death
December 18, 2021
Dealing with the death of a loved one is traumatic. The family left behind are mourning and often find themselves on an emotional rollercoaster that can be overwhelming. There is no timetable for grieving and everyone manages their loss differently. However, unfortunately with death comes bureaucratic paperwork around the deceased personal business. Part of the anxiety can also be financial, especially if it is a breadwinner who has died. This too impacts on everyday life, including healthcare and medical aid cover.
‘The death of a loved one, whatever the circumstances, is never easy to cope with,’ says Kenneth Marion, Chief Operations Officer of Bonitas Medical Fund, ‘We fully understand the trauma of dealing with this which is why we have trained call centre personnel who are sensitive to helping members deal with the necessary paperwork during this time. If a member has a financial adviser or broker, then they will be a great source of help by sorting out all the required documentation.’
To help guide you through the process as sensitively and stress-free as possible and to ensure there is no breakdown in healthcare cover after a family death, we asked Marion some key questions.
What is the correct process to follow regarding notifying the medical aid of the death of a main member?
The call centre staff will guide and support you through this process. However, you will need to notify the medical aid of the death and supply a certifiedcopy of the death certificate and other supporting documentation, such as a change of dependants form.
Are any other documents required?
In the case of a new main member (replacing the deceased) then a copy of their identity document and proof of their banking details are also required to make the necessary changes to the medical aid plan.
Is there a time limit for informing the medical Scheme?
Yes there is, the Scheme Rules outline that this notification must be done within 30 days.
How does death of a main member impact the dependants? Are they still covered by the medical aid for a period of time and if so, how long does this cover last?
If medical aid premiums are collected in advance, the members/dependants will be covered until the end of that month. Thedependants can opt to continue the membership, in which case one of the beneficiaries needs to become the main member.
Who pays the monthly premium once the main member has died?
If membership is continued, the new main member will continue to pay the monthly premiums. However the members do have an option to resign from the current medical aid and take out a new plan.
Will the monthly subscription change after the death of the main member or a dependant?
This is possible as the monthly premiums are based on the number of people and ages of the dependants on the policy. So, if there is one less member the monthly premium could be reduced. However, conversely, depending on the medical aid plan you have selected and the number of dependants the premiums could increase. But remember that we – at Bonitas – offer free cover for your fourth and subsequent children, so you only pay for a maximum of three children.
If the family receives a pension or death benefit from a company that the main member worked for, will the premium still be subsidised by the company for the dependant’s medical aid?
This all depends on the company’s specific rules, dependants need to check with the company.
If dependants are no longer covered, will they need to apply for new medical aid cover? How will this impact on continuity of cover and/or will waiting periods apply?
Dependantsare able to opt to continue with the existing medical aid cover however they do need to appoint a main member and put the appropriate paperwork in place. Or they are free to change plansor move to another medical aid.. However we do need to point out that underwriting rules will apply, especially if there is a break in healthcare cover for more than 90 days.
Is the process the same when notifying about the death of dependant who is on medical aid?
Yes the process of 30 days notification and sending through a death certificate is also required for the death of a dependant.
Does Bonitas offer any funeral cover or life/death benefits for members?
No we do not offer funeral or life cover however, through our multi insurer platform, we have negotiated funeral cover from Sanlam Indie for our members at a reduced monthly premium.
If you belong to a medical aid, consider taking out gap cover to take care of co-payment shortfalls. Complete and then submit the form on this page so we can contact you with a quote.
Bonitas is the second largest open medical scheme in South Africa. Administered by Medscheme Holdings (Pty) Ltd, Bonitas aims to make quality healthcare accessible to all South Africans and offers a wide range of plans that are simple to understand and easy to use. The Fund has the largest GP network in South Africa, a Specialist Network and a host of supplementary benefits paid from risk and carefully crafted managed care programmes to cover chronic conditions, cancer, diabetes and HIV/AIDS. This allows members to derive real value for money and stretch their benefits as far as possible.
All info was correct at time of publishing